Saturday, May 20, 2006

Complications - Review

'An extremely important book'


Atul Gawande's observations on the world of the surgeon is an effortless, slickly written masterpiece. Reading it, I felt it was one of the most important books any medical student might encounter, leading me to consider its potential as being part of the medical school curriculum.

Gawande covers a range of topics, devoting a chapter to each and providing a wide range of anecdotes, examples of cases and scientific literature to lend weight to the discussion. This provides the book a diversity, with analogies to fields other than medicine, making this book equally accessible to laypeople.

The areas considered in the book include practising on patients, fallibility and making mistakes, technology versus surgery, drug companies, motivation, superstition, chronic pain, nausea, obesity, autopsy, cot death, consent and uncertainty. Each are comprehensive and approached objectively, with the author unafraid to admit the flaws in modern medicine.

Not only is the book an educational read, but it allows access into a secretive world. For patients, there is the idea of handing over control to another, as soon as the haze of anaesthesia begins. For them, this book reflects the thoughts and worries of those taking care of them, as well as their own feelings. For medical professionals, this allows us to question our motives and doubts about what Gawande describes as 'an imperfect science'.

A personal drawback was the 'americanism' of the book; Gawande could have aimed at a more worldwide audience (There are a few cultural and geographical references which went over my head). Another aspect I found to be slightly clumsy was the confidentiality; 'A patient with x, whom I'll call Mrs Y'. Gawande already states in the opening pages of his book that he has anonymised his accounts of patients, and it interrupted the flow of the text somewhat.

What did non-medics feel about the book?

2 comments:

Giskin said...

This is a fascinating read and there are lots of nuggets in it that remind us what a human endeavour medicine is. Many of the messages are what we instinctively realise but are reluctant to voice -- like the sacrifices made on the learning curve for new techniques.

xl pharmacy said...

THis is a great book actually I'm studying medicine and I read this book and the reaction I got was perfect actually there were some things I didn't know.